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Adjuvant chemotherapy for advanced nasopharyngeal carcinoma
Author(s) -
Dimery Isaiah W.,
Legha Sewa S.,
Peters Lester J.,
Goepfert Helmuth,
Oswald Mary Jane
Publication year - 1987
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19870901)60:5<943::aid-cncr2820600505>3.0.co;2-u
Subject(s) - medicine , radiation therapy , nasopharyngeal carcinoma , chemotherapy , cisplatin , stage (stratigraphy) , carcinoma , oncology , surgery , survival rate , gastroenterology , paleontology , biology
The outcome of therapy is reported in 34 previously untreated patients with advanced‐stage (AJC IV) nasopharyngeal carcinoma treated with combination chemotherapy (cisplatin and non‐cisplatin based) and sequential radiation therapy. Sixty‐nine patients treated with radiotherapy alone were used as a control group. The control group was matched for T and N stage grouping but differed in that 45% had keratinizing squamous carcinoma, 14.5% had nonkeratinizing squamous carcinoma, and 40.6% had undifferentiated carcinoma, compared with 18%, 50%, and 32.4%, respectively in the combined‐treatment group. Seventeen of 21 patients (81%) who received chemotherapy followed by radiotherapy achieved complete remission (CR), whereas 11 of 13 patients (85%) who received radiotherapy followed by chemotherapy achieved CR ( P = NS). Patients treated by radiotherapy alone had a 91% CR rate. The combined treatment yielded a relapse‐free rate of 78% versus 44% for the radiotherapy group ( P = 0.001). Median survival in the combined‐treatment group has not been reached (111+ months), compared with 67 months in the group receiving radiotherapy alone ( P = 0.04). The recurrence rate at the primary site and in regional nodes was more frequent in the radiotherapy group (36%), compared with the combined‐therapy group (7%) ( P = 0.004), but the occurrence of distant metastases was similar in each group ( P = 0.41). The acute toxicity of the treatment was well tolerated. The major long‐term toxic effect experienced by patients in the combined‐therapy group was soft tissue fibrosis. These data suggest that a prospective trial comparing chemotherapy and radiotherapy versus radiotherapy alone is warranted.